RE: consult charges, documentation

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From:"Jennings-Siena, Debbie" <>
To:'hkcormier' <>,
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Just wanted to let everyone know that on June 21,2000 the American Society
of Clinical Pathologists hosted a consensus conference on second opinions in
diagnostic anatomic pathology.  Ten panelist from around the country,
including eight pathologists of various disciplines, a patient represenative
and a surgeon met in Washington D.C. to debate the who, what, how and when
of second opinions in ap.  They felt that it was important to determine when
second opinion review of Anatomic pathology slides is warranted for patient
care.  The consensus conference is part of the ASCP Patient Safety
Initiative, which was created in response to a report on medical errors
released late last year by the Institute of Medicine.  The Panelists debated
which patients need second opinions, which diagnoses need more frequent
review, and cost and payment issues.  The proceedings of the conference are
expected to be published in an upcoming issue of the American Journal of
Clinical Pathology and on the ASCP web site (  

This was reported in the Washington Report, Dated July 5, 2000.  I hope that
when this information is published that it will be helpful, although not a
total answer to your question.

Debbie J. Siena
NSH Legislative Chairperson
Baylor University Medical Center
Dallas, TX 75246

-----Original Message-----
From: hkcormier []
Sent: Monday, July 10, 2000 6:14 PM
Subject: consult charges, documentation

Hello All,
I have an interesting question for you all, our corporate compliance
program is currently looking at path consult does everyone
(anyone) document physician requests for consults. By this I mean the
patient's doctor calls the office and requests that the case be sent out
to another pathologist, not the "house" pathologist sending our for a
second opinion. Our issue is that we are a fairly small hospital  with
only 2 pathologist, our pathologists will routinely send out cases for a
second opinion, on say bone marrows to the regions top bone marrow guy.
The local visiting oncologist and ocasionally a local surgeon - primary
care physician will request that a case be sent out, some where else.
The issue is, is that it is usually a phone call from the doctor or
doctor's staff and we never receive any written order or request. This
our course would slow us all down and wreck havoc with our customer
service policy. Our corporate people feel that without documentation
from somewhere, this may be construed as fraud.  Any ideas? Any one ever
deal with this before? Any suggestions? Thanks!  Kathy

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